Remote HCC Coding Specialist for Medicare/MA

Highmark Health; Kailua (HI); A distancia; USD 37.000 - 58.000; Jornada completa

Descripción de la vacante

Highmark Inc. is seeking a skilled HCC coder to support Medicare Advantage, ACA, and ESRD projects. You will work with clinicians and teams to ensure accurate ICD-10 and HCC coding, while aligning with CMS guidelines and Highmark policies. This remote position emphasizes RPM coding accuracy and audit support.

The ideal candidate has 3–5 years of HCC coding experience, relevant certifications, and strong analytical and documentation skills to drive quality and compliance across programs.

Formación

• 3 years HCC coding and/or coding and billing
• 5 years HCC coding and/or coding and billing (preferred)
• CDS/CPC/CRC/CCS/RHIT or related certification may be preferred
• Experience with CMS guidelines and RPM coding processes

Responsabilidades

• Performs HCC coding on MA, ACA, and ESRD projects across multiple models.
• Adheres to CMS guidelines and Highmark policy to ensure accurate coding.
• Supports regulatory audits with initial chart review and ranking.
• Collaborates with clinicians and internal teams to improve coding accuracy.

Conocimientos

Critical Thinking

Attention to Detail

Written and Oral Presentation

Written Communications

Communication Skills

HCC Coding

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Educación

Associate degree in medical billing/coding

Herramientas

MS Word

Excel

Outlook

PowerPoint

MS365 & Teams

Descripción del empleo

Highmark Inc. is seeking a skilled HCC coder to support Medicare Advantage, ACA, and ESRD projects. You will work with clinicians and teams to ensure accurate ICD-10 and HCC coding, while aligning with CMS guidelines and Highmark policies. This remote position emphasizes RPM coding accuracy and audit support.

The ideal candidate has 3–5 years of HCC coding experience, relevant certifications, and strong analytical and documentation skills to drive quality and compliance across programs.